Determinants of urgent start dialysis in a chronic kidney disease cohort followed by nephrologists
Abstract Background The French Renal Epidemiology and Information Network (REIN) registry collect dialysis initiation context for each patient starting dialysis with a flawed definition of urgent start dialysis (USD). The main objective of this study was to identify factors associated with USD in pa...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | BMC Nephrology |
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| Online Access: | https://doi.org/10.1186/s12882-023-03222-1 |
| _version_ | 1827910965780283392 |
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| author | Amin Tachikart Clément Vachey Charline Vauchy Caroline Savet Didier Ducloux Cécile Courivaud |
| author_facet | Amin Tachikart Clément Vachey Charline Vauchy Caroline Savet Didier Ducloux Cécile Courivaud |
| author_sort | Amin Tachikart |
| collection | DOAJ |
| description | Abstract Background The French Renal Epidemiology and Information Network (REIN) registry collect dialysis initiation context for each patient starting dialysis with a flawed definition of urgent start dialysis (USD). The main objective of this study was to identify factors associated with USD in patients regularly followed-up by a nephrologist using a classification of USD considering the preparation to renal replacement therapy. Methods This retrospective cohort study included adult patients who started dialysis between 2012 and 2018 in the Franche-Comté region of France after a minimum of two nephrology consultations. We classified dialysis initiation context as follows: USD for patients with no dialysis access (DA) created or planned, unplanned non urgent start dialysis (UNUSD) for patients starting with a recent or non-functional DA and planned start dialysis (PSD) for those starting with a functional and mature DA. Results Four hundred and sixty-five patients met inclusion criteria. According to REIN registry, 94 (20.3%) patients were urgent starters (US) whereas with our classification 80 (17.2%) and 73 (15.7%) where respectively US and unplanned non urgent starters (UNUS). The factors independently associated with USD in our classification were: stroke (odds ratio(OR) = 2.76, 95% confidence interval (95%CI)=[1.41–5.43]), cardiac failure (OR = 1.78, 95%CI=[1.07–2.96]) and the number of nephrology consultations prior dialysis onset (OR = 0.73, 95%CI=[0.64–0.83]). Thirty-one patients died during the first year after dialysis start. According to our classification, we observed significantly different survival probabilities: 95.7%, 89.5% and 83.4% respectively for planned starters, UNUS and US (p = 0.001). Conclusion The two factors independently associated with USD were cardiac failure and stroke. |
| first_indexed | 2024-03-13T01:56:42Z |
| format | Article |
| id | doaj.art-bfd022d614104149955607c4a8c6dfd9 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-03-13T01:56:42Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-bfd022d614104149955607c4a8c6dfd92023-07-02T11:10:04ZengBMCBMC Nephrology1471-23692023-06-012411810.1186/s12882-023-03222-1Determinants of urgent start dialysis in a chronic kidney disease cohort followed by nephrologistsAmin Tachikart0Clément Vachey1Charline Vauchy2Caroline Savet3Didier Ducloux4Cécile Courivaud5Department of Nephrology, Dialysis and Renal Transplantation, Univ Hospital of BesançonDepartment of Nephrology, Dialysis and Renal Transplantation, Univ Hospital of BesançonDepartment of Nephrology, Dialysis and Renal Transplantation, Univ Hospital of BesançonAgence de la Biomédecine, REIN Registry, Saint Denis La Plaine CedexDepartment of Nephrology, Dialysis and Renal Transplantation, Univ Hospital of BesançonDepartment of Nephrology, Dialysis and Renal Transplantation, Univ Hospital of BesançonAbstract Background The French Renal Epidemiology and Information Network (REIN) registry collect dialysis initiation context for each patient starting dialysis with a flawed definition of urgent start dialysis (USD). The main objective of this study was to identify factors associated with USD in patients regularly followed-up by a nephrologist using a classification of USD considering the preparation to renal replacement therapy. Methods This retrospective cohort study included adult patients who started dialysis between 2012 and 2018 in the Franche-Comté region of France after a minimum of two nephrology consultations. We classified dialysis initiation context as follows: USD for patients with no dialysis access (DA) created or planned, unplanned non urgent start dialysis (UNUSD) for patients starting with a recent or non-functional DA and planned start dialysis (PSD) for those starting with a functional and mature DA. Results Four hundred and sixty-five patients met inclusion criteria. According to REIN registry, 94 (20.3%) patients were urgent starters (US) whereas with our classification 80 (17.2%) and 73 (15.7%) where respectively US and unplanned non urgent starters (UNUS). The factors independently associated with USD in our classification were: stroke (odds ratio(OR) = 2.76, 95% confidence interval (95%CI)=[1.41–5.43]), cardiac failure (OR = 1.78, 95%CI=[1.07–2.96]) and the number of nephrology consultations prior dialysis onset (OR = 0.73, 95%CI=[0.64–0.83]). Thirty-one patients died during the first year after dialysis start. According to our classification, we observed significantly different survival probabilities: 95.7%, 89.5% and 83.4% respectively for planned starters, UNUS and US (p = 0.001). Conclusion The two factors independently associated with USD were cardiac failure and stroke.https://doi.org/10.1186/s12882-023-03222-1Advanced chronic kidney diseaseDialysis accessUrgent dialysis startSurvivalFrance |
| spellingShingle | Amin Tachikart Clément Vachey Charline Vauchy Caroline Savet Didier Ducloux Cécile Courivaud Determinants of urgent start dialysis in a chronic kidney disease cohort followed by nephrologists BMC Nephrology Advanced chronic kidney disease Dialysis access Urgent dialysis start Survival France |
| title | Determinants of urgent start dialysis in a chronic kidney disease cohort followed by nephrologists |
| title_full | Determinants of urgent start dialysis in a chronic kidney disease cohort followed by nephrologists |
| title_fullStr | Determinants of urgent start dialysis in a chronic kidney disease cohort followed by nephrologists |
| title_full_unstemmed | Determinants of urgent start dialysis in a chronic kidney disease cohort followed by nephrologists |
| title_short | Determinants of urgent start dialysis in a chronic kidney disease cohort followed by nephrologists |
| title_sort | determinants of urgent start dialysis in a chronic kidney disease cohort followed by nephrologists |
| topic | Advanced chronic kidney disease Dialysis access Urgent dialysis start Survival France |
| url | https://doi.org/10.1186/s12882-023-03222-1 |
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